Archive

Posts tagged "cms&quot

What is Value-Based Care? The Shift from “Volume to Value” At the 2018 Patient-Centered Primary Care Collaborative Annual Conference, Secretary of Health and Human Services (HHS) Alex Azar stressed that payment systems should reward outcomes and prevent or effectively cure diseases long before they cause unnecessary suffering and cost. This emphasizes the move to a […]

Over 75% of the Medicare Advantage plans in the U.S outsource some portion, or all, of their Risk Adjustment programs to third-party vendors. Traditionally, retrospective chart retrieval and reviews make up the bulk of that outsourced work. But as the industry evolved, CMS expanded the approved interventions and acceptable data sources that can be used […]

What is CDI? Clinical Documentation Improvement (CDI) is a process used by healthcare providers to review clinical documentation and provide feedback to physicians that improve that documentation. To make it even simpler – Medical Coding 101 says, “You can only code what you can document.” CDI 101 says, “Let’s fill in the gaps of what’s […]

Just when you thought you would have the annual “spring break” from the Medicare Advantage (MA) retrospective risk adjustment chart reviews, The Centers for Medicare & Medicaid Services (CMS) releases a memo extending the deadline for Risk Adjustment Payment System (RAPS) submissions to May 3, 2018. For those plans and communities impacted by extreme weather […]